| A prospective randomized controlled trial comparing occupational therapy with independent exercises after volar plate fixation of a fracture of the distal part of the radius. | |
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MedLine Citation:
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PMID: 22005860 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effect of formal occupational therapy on recovery after open reduction and volar plate fixation of a fracture of the distal part of the radius is uncertain. We hypothesized that there would be no difference in wrist function and arm-specific disability six months after open reduction and volar plate fixation of a distal radial fracture between patients who receive formal occupational therapy and those with instructions for independent exercises. METHODS: Ninety-four patients with an unstable distal radial fracture treated with open reduction and volar locking plate fixation were enrolled in a prospective randomized controlled trial comparing exercises done under the supervision of an occupational therapist with surgeon-directed independent exercises. The primary study question addressed combined wrist flexion and extension six months after surgery Secondary study questions addressed wrist motion, grip strength, Gartland and Werley scores, Mayo wrist scores, and DASH (Disabilities of the Arm, Shoulder and Hand) scores at three months and six months after surgery. RESULTS: There was a significant difference in the mean arc of wrist flexion and extension six months after surgery (118° versus 129°), favoring patients prescribed independent exercises. Three months after surgery, there was a significant difference in mean pinch strength (80% versus 90%), mean grip strength (66% versus 81%), and mean Gartland and Werley scores, favoring patients prescribed independent exercises. At six months, there was a significant difference in mean wrist extension (55° versus 62°), ulnar deviation (82% versus 93%), mean supination (84° versus 90°), mean grip strength (81% versus 92%), and mean Mayo score, favoring patients prescribed independent exercises. There were no differences in arm-specific disability (DASH score) at any time point. CONCLUSIONS: Prescription of formal occupational therapy does not improve the average motion or disability score after volar locking plate fixation of a fracture of the distal part of the radius. |
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Authors:
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J Sebastiaan Souer; Geert Buijze; David Ring |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of bone and joint surgery. American volume Volume: 93 ISSN: 1535-1386 ISO Abbreviation: J Bone Joint Surg Am Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-18 Completed Date: 2011-12-29 Revised Date: 2012-01-23 |
Medline Journal Info:
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Nlm Unique ID: 0014030 Medline TA: J Bone Joint Surg Am Country: United States |
Other Details:
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Languages: eng Pagination: 1761-6 Citation Subset: AIM; IM |
Affiliation:
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Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey 2100, 55 Fruit Street, Boston, MA 02114, USA. dring@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bone Plates Exercise Therapy* Female Fracture Fixation, Internal* Humans Male Occupational Therapy* Pinch Strength Prospective Studies Radius Fractures / physiopathology, rehabilitation*, surgery* Range of Motion, Articular Recovery of Function Treatment Outcome Volar Plate* |
| Comments/Corrections | |
Comment In:
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Z Orthop Unfall. 2011 Dec;149(6):620 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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